Chinese Journal of Traumatology最新文献

{"title":"Survival predictor in emergency resuscitative thoracotomy for blunt trauma patients: Insights from a Chinese trauma center","authors":"Shan Liu ,&nbsp;Lin Ling ,&nbsp;Yong Fu ,&nbsp;Wen-Chao Zhang ,&nbsp;Yong-Hu Zhang ,&nbsp;Qing Li ,&nbsp;Liang Zeng ,&nbsp;Jun Hu ,&nbsp;Yong Luo ,&nbsp;Wen-Jie Liu","doi":"10.1016/j.cjtee.2024.07.009","DOIUrl":"10.1016/j.cjtee.2024.07.009","url":null,"abstract":"<div><h3>Purpose</h3><div>Emergency resuscitative thoracotomy (ERT) is a final salvage procedure for critically injured trauma patients. Given its low success rate and ambiguous indications, its use in blunt trauma scenarios remains highly debated. Consequently, our study seeks to ascertain the overall survival rate of ERT in blunt trauma patients and determine which patients would benefit most from this procedure.</div></div><div><h3>Methods</h3><div>A retrospective case-control study was conducted for this research. Blunt trauma patients who underwent ERT between January 2020 and December 2023 in our trauma center were selected for analysis, with the endpoint outcome being in-hospital survival, divided into survival and non-survival groups. Inter-group comparisons were conducted using Chi-square and Fisher's exact tests, the Kruskal-Wallis test, Student's <em>t</em>-test, or the Mann-Whitney <em>U</em> test. Univariate and multivariate logistic regression analyses were conducted to assess potential predictors of survival. Then, the efficacy of the predictors was assessed through sensitivity and specificity analysis.</div></div><div><h3>Results</h3><div>A total of 33 patients were included in the study, with 4 survivors (12.12%). Multivariate logistic regression analysis indicated a significant association between cardiac tamponade and survival, with an adjusted odds ratio of 33.4 (95% <em>CI</em>: 1.31 – 850.00, <em>p</em> = 0.034). Additionally, an analysis of sensitivity and specificity, targeting cardiac tamponade as an indicator for survivor identification, showed a sensitivity rate of 75.0% and a specificity rate of 96.6%.</div></div><div><h3>Conclusion</h3><div>The survival rate among blunt trauma patients undergoing ERT exceeds traditional expectations, suggesting that select individuals with blunt trauma can significantly benefit from the procedure. Notably, those presenting with cardiac tamponade are identified as the subgroup most likely to derive substantial benefits from ERT.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 288-293"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relevance of intra-abdominal pressure monitoring in non-operative management of patients with blunt liver and splenic injuries","authors":"Vivek Kumar ,&nbsp;Ramesh Vaidyanathan ,&nbsp;Dinesh Bagaria ,&nbsp;Pratyusha Priyadarshini ,&nbsp;Abhinav Kumar ,&nbsp;Narendra Choudhary ,&nbsp;Sushma Sagar ,&nbsp;Amit Gupta ,&nbsp;Biplab Mishra ,&nbsp;Mohit Joshi ,&nbsp;Kapil Dev Soni ,&nbsp;Richa Aggarwal ,&nbsp;Subodh Kumar","doi":"10.1016/j.cjtee.2024.02.006","DOIUrl":"10.1016/j.cjtee.2024.02.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Non-operative management (NOM) has been validated for blunt liver and splenic injuries. Literature on continuous intra-abdominal pressure (IAP) monitoring as a part of NOM remains to be equivocal. The study aimed to find any correlation between clinical parameters and IAP, and their effect on the NOM of patients with blunt liver and splenic injury.</div></div><div><h3>Method</h3><div>A prospective cross-sectional study conducted at a level I trauma center from October 2018 to January 2020 including 174 patients who underwent NOM following blunt liver and splenic injuries. Hemodynamically unstable patients or those on ventilators were excluded, as well as patients who suffered significant head, spinal cord, and/or bladder injuries. The study predominantly included males (83.9%) with a mean age of 32.5 years. IAP was monitored continuously and the relation of IAP with various parameters, interventions, and outcomes were measured. Data were summarized as frequency (percentage) or mean ± SD or median (Q₁, Q₃) as indicated. χ² or Fisher's exact test was used for categorical variables, while for continuous variables parametric (independent <em>t</em>-test) or nonparametric tests (Wilcoxon rank sum test) were used as appropriate. Clinical and laboratory correlates of IAP &lt; 12 with <em>p</em> &lt; 0.200 in the univariable logistic regression analysis were included in the multivariable analysis. A <em>p</em> &lt; 0.05 was used to indicate statistical significance.</div></div><div><h3>Results</h3><div>Intra-abdominal hypertension (IAH) was seen in 19.0% of the study population. IAH was strongly associated with a high injury severity score (<em>p</em> &lt; 0.001), and other physiological parameters like respiratory rate (<em>p</em> &lt; 0.001), change in abdominal girth (AG) (<em>p</em> &lt; 0.001), and serum creatinine (<em>p</em> &lt; 0.001). IAH along with the number of solid organs involved, respiratory rate, change in AG, and serum creatinine was associated with the intervention, either operative or non-operative (<em>p</em> = 0.001, <em>p</em> = 0.002, <em>p</em> &lt; 0.001, <em>p</em> &lt; 0.001, <em>p</em> = 0.013, respectively). On multivariable analysis, IAP (<em>p</em> = 0.006) and the mean change of AG (<em>p</em> = 0.004) were significantly associated with the need for intervention.</div></div><div><h3>Conclusion</h3><div>As a part of NOM, IAP should be monitored as a continuous vital. However, the decision for any intervention, either operative or non-operative cannot be guided by IAP values alone.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 307-312"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of hook plates vs. locking plates for Neer type IIB fractures of lateral end clavicle: A systematic review","authors":"Ravi Patel ,&nbsp;Muhammad Murtaza Khan ,&nbsp;William Gibson ,&nbsp;Robin Banerjee ,&nbsp;Asif Pardiwala","doi":"10.1016/j.cjtee.2024.03.012","DOIUrl":"10.1016/j.cjtee.2024.03.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Surgical management of the lateral end of clavicle fractures has been a challenge for orthopedic surgeons considering the high rate of non-union. There has been no right and wrong answer to these types of fractures and many methods discussed in the literature, but the 2 most used bony procedures are hook plate and locking plate with or without the use of supplementary soft tissue procedures. The available evidence, in this case, is scarce with questionable reliability. The idea of this systemic review is to promote evidence-based practice when choosing between the 2 implants for this fracture. This study aims to review the results by performing a systemic review of the literature comparing the results of locking plate &lt;em&gt;vs&lt;/em&gt;. hook plate for the lateral end of clavicle fracture fixation with an emphasis on outcome and associated complications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A search of the literature was made with the keyword “clavicle” in PubMed/Ovid Medline/Embase and University of Edinburgh online library “discover Ed”. A total of 4063 articles were identified including case series (with at least 3 cases) and review articles focusing on locking plate alone, comparisons of locking plate and hook plate, or hook plate alone. Articles were excluded if they were not published in English, focused on pediatric studies, or consisted only of book chapters. Studies examining tension band wiring, soft tissue procedures for fracture fixation, arthroscopic-assisted procedures, additional soft tissue procedures along with plate fixation, and fracture dislocation of the lateral end of the clavicle were also excluded. The search was then narrowed down to 21 articles after consideration of inclusion and exclusion criteria. A detailed review of the surgical methodology further excluded additional soft tissue procedures, resulting in a final selection of 15 studies. The quality of the studies was assessed using the Modified Coleman Score by the authors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 15 studies related to Neer type II fracture met the inclusion criteria. However, 2 other studies also included type V fracture as well. The mean age of patients in these studies was 32 years. The mean follow-up period was 24.3 months (ranging from 6 to 65 months). The time of radiological union was documented from 2 to 4.5 months. Constant and disabilities of arm, shoulder, and hand scores were most used as the criteria for patient outcomes. The size of the lateral fragment that can accommodate/provide bicortical fracture was documented in only 3 studies. The mean incidence of removal of hook plate was 86.9%. In contrast, the mean incidence of removal of locking plate was 27.0%. Superficial wound infection was documented in 5 studies and deep wound infection was seen in 1 study. The mean union rate for hook plate was 97.0% compared to 100% for locking plate. Complications associated with hook plate have been documented in 11 studi","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 269-275"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NINJ1 impairs the anti-inflammatory function of hUC-MSCs with synergistic IFN-γ and TNF-α stimulation","authors":"Wang Hu ,&nbsp;Guomei Yang ,&nbsp;Luoquan Ao ,&nbsp;Peixin Shen ,&nbsp;Mengwei Yao ,&nbsp;Yuchuan Yuan ,&nbsp;Jiaoyue Long ,&nbsp;Zhan Li ,&nbsp;Xiang Xu","doi":"10.1016/j.cjtee.2025.04.003","DOIUrl":"10.1016/j.cjtee.2025.04.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To investigate the regulatory role of nerve injury-induced protein 1 (NINJ1) in the anti-inflammatory function of human umbilical cord mesenchymal stem cells (hUC-MSCs) co-stimulated by interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;hUC-MSCs were expanded &lt;em&gt;in vitro&lt;/em&gt; using standard protocols, with stem cell characteristics confirmed by flow cytometry and multilineage differentiation assays. The immunomodulatory properties and cellular activity of cytokine-co-pretreated hUC-MSCs were systematically evaluated via quantitative reverse transcription RT-qPCR, lymphocyte proliferation suppression assays, and Cell Counting Kit-8 viability tests. Transcriptome sequencing, Western blotting and small interfering RNA interference were integrated to analyze the regulatory mechanisms of NINJ1 expression. Functional roles of NINJ1 in pretreated hUC-MSCs were elucidated through gene silencing combined with lactate dehydrogenase release assays, Annexin V/Propidium Iodide apoptosis analysis, macrophage co-culture models, and cytokine Enzyme-Linked Immunosorbent Assay. Therapeutic efficacy was validated in a cecal ligation and puncture-induced septic mouse model: 80 mice were randomly allocated into 4 experimental groups (&lt;em&gt;n&lt;/em&gt;=20/group): sham group (laparotomy without cecal ligation); phosphate-buffered saline-treated group (cecal ligation and puncture (CLP) + 0.1 mL phosphate-buffered saline); hUC-MSCs (small interfering RNA (siRNA)-interferon-gamma and tumor necrosis factor-alpha co-stimulation (IT))-treated group (CLP + hUC-MSCs transfected with scrambled siRNA); and hUC-MSCs (siNINJ1-IT)-treated group (CLP + hUC-MSCs with NINJ1-targeting siRNA).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;hUC-MSCs demonstrated compliance with International Society for Cellular Therapy criteria, confirming their stem cell identity. IFN-γ/TNF-α co-pretreatment enhanced the immunosuppressive capacity of hUC-MSCs, accompanied by the reduction of cellular viability, while concurrently upregulating pro-inflammatory cytokines such as interleukin-6 and interleukin-1β. This co-stimulation significantly elevated NINJ1 expression in hUC-MSCs, whereas genetic silencing of NINJ1 effectively suppressed pro-inflammatory cytokine production and attenuated damage-associated molecular patterns release through inhibition of programmed plasma membrane rupture. Furthermore, the NINJ1 interference potentiated the ability of cytokine-pretreated hUC-MSCs to suppress LPS-induced pro-inflammatory responses in RAW264.7 macrophages. In cecal ligation and puncture-induced sepsis model, NINJ1-silenced hUC-MSCs exhibited enhanced therapeutic efficacy, manifested by reduced systemic inflammation and multi-organ damage.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Our findings shed new light on the immunomodulatory functions of cytokine-primed MSCs, offering groundbreaking insights for developing MSC-based therapies against infl","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 276-287"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When to choose intraosseous access in prehospital trauma care: A registry-based study from the Israel Defense Forces","authors":"Mor Rittblat ,&nbsp;Nir Tsur ,&nbsp;Adi Karas ,&nbsp;Sami Gendler ,&nbsp;Zivan Beer ,&nbsp;Irina Radomislensky ,&nbsp;Ofer Almog ,&nbsp;Avishai M. Tsur ,&nbsp;Guy Avital ,&nbsp;Tomer Talmy","doi":"10.1016/j.cjtee.2024.08.008","DOIUrl":"10.1016/j.cjtee.2024.08.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Prompt vascular access is crucial for resuscitating bleeding trauma casualties in prehospital settings but achieving peripheral intravenous (PIV) access can be challenging during hemorrhagic shock due to peripheral vessel collapse. Early intraosseous (IO) device use is suggested as an alternative. This study examines injury characteristics and factors linked to IO access requirements.</div></div><div><h3>Methods</h3><div>A registry-based cohort study from the Israel Defense Forces Trauma Registry (2010 – 2023) included trauma casualties receiving PIV or IO access prehospital. Casualties who had at least one documented PIV or IO access attempt were included, while those without vascular access were excluded. Casualties requiring both PIV and IO were classified in the IO group. Univariable logistic regression assessed the factors associated with IO access. Results were reported as odds ratios (<em>OR</em>) with 95% confidence intervals (<em>CI</em>), and significant difference was set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Of 3462 casualties (86.3% male, the median age: 22 years), 3287 (94.9%) received PIV access and 175 (5.1%) had IO access attempts. In the IO group, 30.3% received freeze-dried plasma and 23.4% received low titer group O whole blood, significantly higher than that in the PIV group. Prehospital mortality was 35.0% in the IO group. Univariable analysis showed significant associations with IO access for increased PIV attempts (<em>OR</em> = 1.69; 95% <em>CI</em>: 1.34 – 2.13) and signs of profound shock (<em>OR</em> = 11.0; 95% <em>CI</em>: 5.5 – 23.3).</div></div><div><h3>Conclusion</h3><div>Profound shock signs are strongly linked to the need for IO access in prehospital settings with each successive PIV attempt increasing the likelihood of requiring IO conversion. IO access often accompanies low titer group O whole blood or freeze-dried plasma administration and higher prehospital mortality, indicating its use in emergent resuscitation situations. Early IO consideration is advised for trauma casualties with profound shock.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 294-300"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of training-related abdominal injuries: A multicenter survey study","authors":"Chuan Pang ,&nbsp;Wen-Quan Liang ,&nbsp;Gan Zhang ,&nbsp;Ting-Ting Lu ,&nbsp;Yun-He Gao ,&nbsp;Xin Miao ,&nbsp;Zhi-Da Chen ,&nbsp;Yi Liu ,&nbsp;Wen-Tong Xu ,&nbsp;Hong-Qing Xi","doi":"10.1016/j.cjtee.2024.09.003","DOIUrl":"10.1016/j.cjtee.2024.09.003","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to identify the prevalence and risk factors of military training-related abdominal injuries and help plan and conduct training properly.</div></div><div><h3>Methods</h3><div>This questionnaire survey study was conducted from October 2021 to May 2022 among military personnel from 6 military units and 8 military medical centers and participants’ medical records were consulted to identify the training-related abdominal injuries. All the military personnel who ever participated in military training were included. Those who refused to participate in this study or provided an incomplete questionnaire were excluded. The questionnaire collected demographic information, type of abdominal injury, frequency, training subjects, triggers, treatment, and training disturbance. Chi-square test and <em>t</em>-test were used to compare baseline information. Univariate and multivariate regression analyses were used to explore the risk factors associated with military training-related abdominal injuries.</div></div><div><h3>Results</h3><div>A total of 3058 participants were involved in this study, among which 1797 (58.8%) had suffered training-related abdominal injuries (the mean age was 24.3 years and the service time was 5.6 years), while 1261 (41.2%) had no training-related abdominal injuries (the mean age was 23.1 years and the service time was 4.3 years). There were 546 injured patients (30.4%) suspended the training and 84 (4.6%) needed to be referred to higher-level hospitals. The most common triggers included inadequate warm-up, fatigue, and intense training. The training subjects with the most abdominal injuries were long-distance running (589, 32.8%). Civil servants had the highest rate of abdominal trauma (17.1%). Age ≥ 25 years, military service ≥ 3 years, poor sleep status, and previous abdominal history were independent risk factors for training-related abdominal injury.</div></div><div><h3>Conclusion</h3><div>More than half of the military personnel have suffered military training-related abdominal injuries. Inadequate warm-up, fatigue, and high training intensity are the most common inducing factors. Scientific and proper training should be conducted according to the factors causing abdominal injuries.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 301-306"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative epidemiology and treatment outcomes at trauma centers: A cross-national analysis of the United States and China.","authors":"Yong Fu, Liu-Yi Fan, Xin-Jie Luo, Lei Li, Delbrynth P Mitchao, Kenji Inaba, Guan-Qiao Liu, Bin Yu","doi":"10.1016/j.cjtee.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.03.001","url":null,"abstract":"<p><strong>Purpose: </strong>Although there are significant differences between China and the United States (US) in trauma medical services, there has been no direct comparative research on the epidemiological data of trauma centers between the 2 countries. This study aims to fill this research gap by directly comparing trauma centers in China and the US, providing valuable data and insights for the development of trauma centers in both countries, promoting academic exchange and cooperation internationally, and enhancing the level of global trauma medical care.</p><p><strong>Methods: </strong>This is a multicenter retrospective descriptive study. Data were collected for trauma patients with an injury severity score ≥16 treated from September 2013 to September 2019 at 2 hospital trauma centers in these 2 countries. Detailed clinical data (including injury mechanism, age, injury site, injury severity score, pre-hospital transport time, whether blood transfusion was performed, whether resuscitative thoracotomy was conducted, hospital and intensive care unit stay duration, the number of organ donor patients, mortality rates, and costs) were meticulously compiled and retrospectively analyzed to identify differences between the 2 trauma centers. The comparison was conducted using SPSS 23 software. Continuous variables are reported as median (Q₁, Q₃), and Mann Whitney U test is used to compare the median of continuous variables. Use clinically relevant critical points to classify continuous variables, with categorical variables represented as n (%), and comparisons were made between the 2 groups using the χ² test or Fisher's exact test. Statistical significance was defined as a 2-sided p < 0.05.</p><p><strong>Results: </strong>These results point to significant differences in trauma center capacity, pre-hospital transport times, treatment procedures, hospital stay duration, mortality rates, and costs between the 2 centers. The volume of patients in trauma centers is less in China (2465 vs. 5288). Pre-hospital transport time was notably longer in China (180 min vs. 14 min), and the rate of emergency blood transfusions was lower in China (18.4% vs. 50.6%), Emergency thoracotomy was not performed in China but was conducted in 9.8% of cases in the US. Hospitalization costs were significantly lower in China than in the US ($5847 vs. $75,671).</p><p><strong>Conclusion: </strong>There are clear differences in trauma center capacity (number of patients treated), pre-hospital transport time, age distribution of injured patients, injury mechanisms, injury sites, whether emergency thoracotomy is performed, hospital costs, and length of stay between the 2 trauma centers in China and America. Understanding these differences can help us further recognize the characteristics of Eastern and Western trauma patients.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical determinants for survival following emergency thoracotomy in trauma patients: An 8-year experience from a level 1 trauma center.","authors":"Abhinav Kumar, Ramesh Vaidyanathan, Pratyusha Priyadarshini, Dinesh Bagaria, Narendra Choudhary, Junaid Alam, Sushma Sagar, Amit Gupta, Biplab Mishra, Mahroof Khan, Subodh Kumar","doi":"10.1016/j.cjtee.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.02.004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Emergency thoracotomy (ET) is a life-saving procedure performed during emergency resuscitation of patients in extremis. The controversy around such an invasive and resource-consuming procedure still lingers after so many years of its introduction. ET can serve as one of several indicators of trauma center efficiency and with information about the trauma system's overall preparedness, resources, and training. Our goal was to examine the clinical determinants of improved outcomes and review our ET experience over the past 8 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;All patients who underwent ET during the study period from January 2014 to December 2021 at our hospital were included in this retrospective study. Patients in whom the time of arrest was not known or who had incomplete data were excluded. Also, patients with fixed, dilated pupil on arrival with a significant blunt trauma were excluded. Patients undergoing urgent thoracotomy (not as a part of primary survey/resuscitation) were also not included in the study. All data were collected from the prospectively maintained hospital registry and patient case files. The primary outcome measure was in-hospital mortality and various parameters affecting it including but not limited to patient demographics, prehospital information, injury characteristics and scores, parameters of primary survey and perioperative data. The secondary outcome measures were the clinical spectrum of injury in patients with torso trauma who underwent ET including complications. The data was analysed using Fisher's exact test, Chi-square test or Wilcoxon rank-sum test based on the category of variables. A Kaplan-Meier survival curve was plotted on relevant factors which determined clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixty-seven patients underwent ET, with the majority (94.0%) being young males with a median age of 27 years. Penetrating injuries (61.2%) were more common than blunt trauma. Overall survival was 46.3%, with the best outcomes seen with penetrating stab (61.1%) injuries and patients with isolated intrathoracic injuries (67.5%). Patients who underwent resuscitative thoracotomy had dismal outcomes (mortality: 100%). On arrival, hemodynamic parameters like airway status, heart rate, systolic blood pressure, signs of life, and shock at presentation are statistically significant predictors of mortality (p &lt; 0.05). The log-rank test for equality of survivor functions revealed the mechanism of injury (p = 0.010), the status of the airway (p = 0.002), shock on presentation (p = 0.001), and initial GCS (p = 0.040) to be significantly associated with mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;ET can be a life-saving procedure with good outcomes, provided a careful selection of patients based on the mechanism of injury, location of major injury, and signs of life. It is prudent to have a system with proper protocol and a swiftly acting trauma team performing it to optimize the out","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To compare the clinical outcomes of intra-capsular vs. extra-capsular lateral retinacular release in the treatment of excessive lateral pressure syndrome of patella using two novel surgical techniques: A retrospective comparative study.","authors":"Minghao Li, Weili Shi, Jianli Gao, Yueyang Hou, Yuping Yang, Guoqing Cui","doi":"10.1016/j.cjtee.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.01.004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To retrospectively compare the clinical outcomes of intra-capsular vs. extra-capsular release of the lateral patellar retinaculum using 2 novel surgical techniques: the capsule-uncut immaculate lateral retinacular release (CUI method), and the L-shaped lateral retinacular release (L-shaped release).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a retrospective comparative study. The clinical data of patients admitted to our department between October 2010 and October 2020 were retrospectively analyzed. Patients diagnosed with excessive lateral pressure syndrome and treated with arthroscopic retinacular release, with complete imaging data, and followed up for &gt;1 year were included in the study. Previous history of knee surgery, cruciate ligament or collateral ligament ruptures, neoplastic diseases of the knee, patellar instability, history of knee fracture, varus/valgus of the knee joint, or Q angle &gt;20° were exclusion criteria. All the included cases were divided into 2 groups based on the surgical method and subsequently stratified by age. The visual analogue pain scale was used to evaluate the degree of knee pain. Lysholm score and the International Knee Documentation Committee knee evaluation form score were used to evaluate knee function and activity. The preoperative and postoperative patellar tilt angles of the affected knee were measured. Comparison between groups was performed by the Wilcoxon test or the Mann-Whitney U test. Count data was represented by frequency, and comparison between groups was performed by χ&lt;sup&gt;2&lt;/sup&gt; test. Mann-Whitney U test and multiple linear regression model were used for univariate and multivariate analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The clinical data of 200 patients were retrospectively analyzed. After screening by inclusion and exclusion criteria, 90 cases met the inclusion and exclusion criteria and were included in this study. The postoperative visual analogue scale scores of both groups were significantly lower than those before operation (p&lt;0.001), and the postoperative Lysholm score and the score of the postoperative International Knee Documentation Committee knee evaluation form of the 2 groups were significantly higher than those before operation (p&lt;0.001). The L-shaped release group was significantly higher than the CUI method group in Lysholm score (p=0.008). In the age ≥50 years group, the Lysholm score of the CUI method group was significantly lower than the L-shaped release group (p&lt;0.001), and the changes in patellar tilt angle were significantly larger in the CUI method group than in the L-shaped release group (p=0.016). In the age &lt;50 years group, there was no significant difference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Both the surgical methods have good clinical effects. L-shaped release is superior to the CUI method in improving knee function in the elderly patients (≥50 years old), while the CUI method is superior to L-shaped release in correcting patellar tilt","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible intramedullary nails for the treatment of metacarpal fractures: A systematic review.","authors":"Oliver Scott Brown, Toby Oliver Smith, Ravi Kanth Mallina","doi":"10.1016/j.cjtee.2024.08.013","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.08.013","url":null,"abstract":"<p><strong>Purpose: </strong>Flexible intramedullary nails (FIN) enable minimally invasive and immediate fracture stabilisation, while facilitating early active movement in metacarpal fractures. This systematic review aims to compare locked, non-locked, single, and double FIN and their post-operative outcomes in metacarpal fractures.</p><p><strong>Methods: </strong>A primary literature search was performed on July 15, 2024. English-language studies investigating acute metacarpal fractures, treated with FIN were included. Analyses included: the 5th metacarpal neck fractures locked vs. non-locked FIN; 5th metacarpal neck fractures non-locked single vs. dual FIN; and the 2nd-5th metacarpal fractures locked vs. non-locked FIN. The National Institute for Health tool and the JBI tool were used to assess study quality for controlled trials and case series, respectively.</p><p><strong>Results: </strong>Thirteen studies (n = 649 fractures) were eligible, with 12 low risks of bias. There was no difference in overall complication rates between locked and non-locked, and single and double non-locked FIN. Non-locked FIN demonstrated reduced metacarpophalangeal joint penetration (odds ratio (OR): 3.30 (95% confidence interval (CI): 1.23-8.80; p=0.017 and delayed union (OR: 6.95; 95% CI: 1.86-25.97; p=0.004), but increased tendon irritation (OR: 0.19; 95% CI: 0.05-0.83; p=0.027 vs. locked FIN. Overall operative times were lower for single vs. double non-locked nails (mean difference: 9.17; 95% CI: 6.12-12.22; p<0.001).</p><p><strong>Conclusions: </strong>These findings demonstrate low complication rates and excellent functional results using FIN to fix displaced metacarpal fractures. Although complication profiles are contrasting, there is no clear benefit in using locked or double nails compared to a single non-locked FIN.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}